Outrage of the Month: The Shocking Abandonment of Ongoing USAID-Funded Clinical Trials
Health Letter, March 2025
By Robert Steinbrook, M.D.
Director, Public Citizen's Health Research Group
If you’re not outraged,
you’re not paying attention!
Read what Public Citizen has to say about the biggest blunders and outrageous offenses in the world of public health, published monthly in Health Letter.
In February 2025, as part of the Trump administration’s attempted shutdown of the U.S. Agency for International Development (USAID), clinical trials funded by the agency were abruptly halted, jeopardizing the participants in the trials and the integrity of the research.
More than 30 studies that had already enrolled volunteers were frozen, including trials of treatments for malaria, cholera, tuberculosis and human immunodeficiency virus (HIV) infection, the New York Times reported. Some of the trials had thousands of participants.
Stopping ongoing clinical trials for reasons that are not scientifically sound is an egregious violation of clinical research ethics and defies common sense. When trials are stopped earlier, it is typically for a valid reason, such as the drug or medical device under study being more effective than anticipated, clearly not effective, or harmful. Halting a trial because of a government’s out-of-the-blue withdrawal of funding was, until now, unheard of.
The United States is a signatory to the World Medical Association Declaration of Helsinki, which spells out the ethical principles for research involving human participants. Researchers have ethical obligations and duties of care to human participants in research, including caring for them throughout a trial, ensuring their access to medical care, safety monitoring, and publicly reporting the results in a timely fashion so the information can advance medical knowledge.
A U.S. researcher who had to stop a study that had enrolled 11 pregnant persons in Lesotho told Science magazine:
I feel ashamed because people agreed to work with me and they’ve been screwed. … They signed an agreement that we would provide ultrasounds, syphilis testing, and other things, and we would follow their infants for 6 months. And…we have reneged on this contract.
And in an opinion article, two bioethicists at Johns Hopkins University’s Bloomberg School of Public Health wrote:
Telling a medical researcher they must abruptly abandon study participants is akin to telling a surgeon they cannot treat a patient who has a post-operative infection that resulted from surgery they performed the week before. All medical ethics codes forbid this. And for obvious reason.
When a study is stopped early, regardless of the reason, the discontinuation should be controlled. The requirements include explaining to the volunteers the reason the study is ending early, providing for adequate medical care and potentially a supply of the research treatment or other treatment options, and removing any investigational medical devices that may have been placed in the bodies of participants.
As of late February, ongoing lawsuits sought to restart USAID funding, including for the stopped clinical trials. The outcome of the litigation and the lasting effects of interrupting the research remain uncertain, however. Even if some of the clinical trials can be salvaged, the very fact that they were abandoned midcourse is appalling and may undermine trust in medical research. Although I hope that Trump administration officials learn from this egregious mistake, I am not confident that they will.